Diagnosing and Treating Anger Issues in Children

Dr. Tali Shenfield | September 28, 2020

Angry meltdowns and childhood go hand in hand. Kids’ natural impulsivity and lack of perspective make them prone to lashing out over apparently minor issues—particularly during early childhood. Being denied something they want, being criticized even in a constructive way, or being teased can all spark disproportionately intense fits of rage.

            For parents, it can be difficult to know how much anger is too much. Figuring out how to deal with a child’s anger constructively is also challenging. Childhood anger is at once simple and complex, after all. While angry outbursts can usually be traced to an obvious (albeit sometimes minor) cause, the roots of chronic anger can be hard to understand. Contrary to popular belief, anger can be a problem unto itself for kids—it’s not always a sign that the child in question has a learning disability or mental illness. (Though frequent angry episodes can indeed be a symptom of ADHD, bipolar disorder, oppositional defiant disorder, Autism, etc.) As such, many mental health professionals believe that anger problems warrant a closer look.

            Some experts have suggested that a tendency to have inappropriate angry outbursts in adulthood should be classified as an “intermittent anger disorder.” While little research has been done into childhood intermittent anger (which manifests differently and requires its own treatment protocol), we do have a basic idea of how this syndrome works in children. Generally, the term “anger overload” is used to describe unusually intense and easily triggered rage in children. Here’s what we currently know about identifying and treating anger overload:

What Differentiates Anger Overload from Normal Anger?

Anger overload is characterized by a “hair trigger” temper. While no child enjoys being told “no,” kids and preteens who experience anger overload will often start screaming, throwing things, etc. even if they are denied something relatively minor. (For example, being told that they can’t use the TV.) They react in this extreme manner because they feel as though they’re being insulted or rejected when their parents try to set perfectly normal limits. This pattern of overreaction invariably spills out into their interactions with peers, too. Kids with anger overload often lash out at their friends if a game doesn’t go their way or if it’s not played by their rules. These kids are not necessarily chronic bullies, or even habitually unpleasant, however. Many kids who experience anger overload can be kind and even charming until something sets off their temper.

Another way to distinguish anger overload from a typical tantrum is the duration of the intense anger the child experiences. During a normal tantrum, a child will usually act out severely for about two or three minutes, then calm down. Anger overload, on the other hand, has been known to last for up to an hour. Likewise, a child who is having a tantrum will usually respond to soothing words and other acts of reassurance, whereas a child in the midst of anger overload will not. Finally, most children can dial back their anger when they realize they’re at risk of engendering serious consequences, such as a loss of important privileges. Kids with anger overload, however, will carry on screaming, hitting, and throwing things regardless of what the fallout will be.

Unsurprisingly, the impulsive nature that these children exhibit when expressing anger carries over into other aspects of their personality, too. These kids tend to be risk-takers and somewhat defiant; as a result, they may be deeply admired by their peers, who perceive them as being brave and daring. It is important for parents not to mistake this trait for all-encompassing confidence, however. Research shows that these children, while bold in some situations, can actually be quite insecure when it comes to tackling things they’re unsure about. This is another potential cause of outbursts: These kids may act out when, for example, they have to do a school assignment that might reveal academic weaknesses they’re struggling with. Learning Disabilities and ADHD, can therefore greatly complicate anger overload.

            If you believe your child is struggling with anger issues, you’ll have to be aware of the risk that he (or she) will be misdiagnosed with bipolar disorder. It’s important to know that bipolar disorder does not manifest solely in the form of angry episodes; mania, grandiosity, mood swings, hypersexuality, and other forms of inappropriate behaviour will also be present. Furthermore, the anger that bipolar children experience often lasts even longer than anger overload. It’s not unusual for bipolar rage to last for several hours.

            Other common misdiagnoses for children with anger overload are ADHD and Oppositional Defiant Disorder. While it’s true that these conditions may co-occur with anger overload, they don’t always. Be on the lookout for additional signs like chronic distractibility that occurs even when your child is calm—this is a hallmark of ADHD. (Kids with anger overload focus normally when they’re not having an outburst.) When it comes to defiance, you should weigh up how consistent your child is. Children with ODD are disobedient to all authority figures almost all of the time. Kids with anger overload, on the other hand, are often happy to go along with demands that don’t trigger their anger. For example, if a child with anger overload doesn’t mind walking the dog, he’s unlikely to react with rage when he’s asked to do it. A kid with ODD, on the other hand, might angrily refuse the request simply because he feels like he’s being “told” to do something. Kids with anger overload can be cooperative sometimes, or even most of the time, whereas ODD children typically are not.

Treating Anger Overload

First and foremost, it’s important to be aware that ignoring your child’s tantrums probably will not yield favourable results if your child experiences anger overload. Instead, these kids need to be taught behaviour modification strategies. Parents are advised to work closely with a mental health professional in order to develop methods of teaching their child better self-control. Remember: Your child is not capable of thinking clearly once his anger grips him, so you’ll need to be fully prepared to act as his guide. It will be extremely important for you to learn how to remain calm and give your child the “cues” he needs to recognize what’s happening and remember what to do about it. Here are some steps you can take to help your child cope with anger overload:

  • Learn to recognize the signs that your child is on the verge of getting angry. Most parents of children with anger issues feel like their child gets mad “out of nowhere.” On closer inspection, however, there are usually subtle indicators that a child is getting upset. Pay attention to the look in your child’s eyes, the tone of his voice, and his body language; you may start to pick up on the signs that suggest an outburst is imminent.
  • Try to distract your child before he has a meltdown. Sometimes a pleasant distraction can “short circuit” the buildup of anger. The distraction you use must be something genuinely interesting to your child in order for this strategy to work, however. If it is not, it won’t succeed in dominating his attention and his angry thoughts will persist.

Note that “active” distractions often work well for children with anger issues because being active helps them to shed their pent-up energy. Suggesting a trip to the park or a game of catch, for instance, will work much better than asking your child to read or watch TV.

  • Provide your child with alternatives to anger. Kids often use anger to express themselves because they’re not sure how else to do so. As such, you should give your child plausible alternatives to losing his temper, such as going and hitting a pillow when he’s upset, or asking for a time out. Reward your child when he uses these alternatives and administer immediate but fair and brief disciplinary measures when he does not. Understand that consequences are just as essential as rewards when it comes to teaching kids the parameters of acceptable behaviour.
  • Set up a reward system. Most children react well to “point systems” that permit them to earn rewards, and children with anger overload are no exception. Giving your child a point every time he manages to control his temper and then allowing him to redeem his accumulated points at the end of the week (for a material treat or special privileges) can effectively motivate him to change his behaviour. (Note that immediate rewards, such as verbal praise, are necessary too. Praise helps a child to recognize and remember exactly what he is doing “right.”)

Kids with anger overload often require a lot of time to really put new habits into practice, so you shouldn’t expect to see profound results soon after creating a reward system. However, if you stick with it, it will help your child gradually “train” his brain over time.

  • Limit discussion when your child is mad. Attempting to discuss your child’s behaviour with him when he’s actively angry is likely to lead to arguing rather than useful discourse. Moreover, your child’s brain will interpret your attention as a “reward,” so lecturing will only reinforce your child’s behavioural pattern.
  • If your child experiences anger overload and has ADHD, work on the anger first. In order for your child to be able to work on issues like distractibility and disorganization, he’ll first need to learn how to control his temper. Otherwise, the various interventions made by parents and teachers are likely to set off an outburst rather than help him stay on track.

Additionally, you should talk to your child about why requests to focus and normal consequences like “time outs” upset him so much. Ask him if he feels criticized, embarrassed, singled out, or put on the spot. Working through these feelings and reassuring your child that he’s not being punished for being “different” may help mitigate his anger.

Finally, be aware that if your child is taking a stimulant medication to help control his ADHD, this may be making his anger more intense. Talk to your doctor about exploring other options if you feel your child’s medication is worsening the symptoms of anger overload. Trying another approach, such as combining an SSRI with a low dose of stimulant medication, may yield better results.

  • Teach your child to be calm yet assertive when he feels embarrassed or humiliated. As mentioned previously, most children who experience anger overload are acutely sensitive to perceived rejection. Even normal limit setting can feel like a personal attack to them, so they fight back vehemently. Unfortunately, this creates a toxic cycle when dealing with peers; the child’s anger at perceived rejection will often cause his peers to actually reject him.

You can’t expect your child to stop feeling the way he does, but you can teach him more effective strategies for dealing with these emotions. Teach him how to respond to others assertively, but without losing his cool in the process. For example, if he feels singled out by a teacher yelling at him to “Pay attention” in class, he can try asking the teacher to use a gentler phrase, such as, “John, are you getting all of this down?” Or he can request that the teacher approach his desk and talk to him privately. Mastering embarrassing and hurtful situations in this way will help your child feel more confident and less out of control. This will mitigate much of the shame that drives him to lash out at others.

  • Remind your child that it’s okay to make mistakes. Most kids with anger overload hold themselves to very high standards; this, too, can worsen feelings of rejection and humiliation. It’s important to teach your child that it’s normal and “okay” to mess up sometimes and that he’s not going to be judged for making innocent mistakes. Asking him to repeat a simple catchphrase in his head when he makes an error (something like “Everyone makes mistakes”) can help him defuse feelings of shame before they get the better of him.
  • Help your child learn better risk assessment skills. Another area where having a catchphrase can be useful is dealing with risk-taking tendencies. Having a phrase like, “Is this risk worth it?” mentally at the ready can help your child slow his impulses down and think things through.
  • Develop a simple “calm down” signal to use when your child is getting upset. An easy-to-interpret gesture, such as a raised hand, can tell your child when he needs to take a deep breath and calm down (without making him feel criticized or embarrassed). Talk to your child about agreeing on a nonverbal signal that he’s comfortable with you using, even in public. Make sure he knows that the chosen gesture is meant to be helpful and not a threat or punishment.

By using the strategies above and modeling constructive conflict skills for your child, you can help him to gain control over anger overload. This will enhance his self-esteem and enable him to have healthier adult relationships. Remember, however, that you shouldn’t attempt to deal with anger overload on your own. Working with an objective mental health professional can provide the insight and mediation that you and your child need in order to deal with this challenging condition effectively.

About Tali Shenfield

Dr. Tali Shenfield holds a PhD in Psychology from the University of Toronto and is a licensed school and clinical psychologist. She has taught at the University of Toronto and has worked at institutions including the Hospital for Sick Children, Hincks-Dellcrest Centre, TDSB, and YCDSB. Dr. Shenfield is the Founder and Clinical Director of Advanced Psychology Services.

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